Formulary
Sparsentan: Indications, Dosing, Side Effects and Interactions
Sparsentan is a dual antagonist which inhibits activation of endothelin and angiotensin II receptors, thereby reducing proteinuria and slowing disease...
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Sparsentan: Indications, Dosing, Side Effects and Interactions
Sparsentan is a dual antagonist which inhibits activation of endothelin and angiotensin II receptors, thereby reducing proteinuria and slowing disease...
Drug action
Sparsentan is a dual antagonist which inhibits activation of endothelin and angiotensin II receptors, thereby reducing proteinuria and slowing disease progression.
Indications and dose
**Primary immunoglobulin A (IgA) nephropathy**
- **Adult** (By Mouth): Initially 200 mg once daily for 14 days, then maintenance 400 mg once daily, for dose adjustments, treatment interruption or discontinuation due to side-effects-consult product literature.
Cautions
Elderly; heart failure; hypotension; renal artery stenosis Cautions, further information Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information). Potentially inappropriate: with hyperkalaemia with persistent postural hypotension i.e. recurrent drop in systolic blood pressure 20 mmHg (risk of syncope and falls)
Contraindications
Avoid concomitant use with other drugs that affect the renin-angiotensin aldosterone system e.g. ACE inhibitors, angiotensin II receptor antagonists, aliskiren (specialist supervision required if dual blockade is considered essential); Avoid concomitant use with other endothelin receptor antagonists; Do not initiate if serum-potassium concentration above 5.5 mmol/litre
Side effects
Common or very common Dizziness; fatigue; headache; hyperkalaemia; hypotension; peripheral oedema; renal impairment Uncommon Anaemia Frequency not known Fluid retention
Interactions
**Severe interactions:**
- Gastric acid reducing agents Based on population pharmacokinetic (PK) analysis, concomitant use of an acid-reducing agent during sparsentan treatment would not have a statistically significant...
- Co-administration of sparsentan with P-gp inhibition substrate should be done with caution if it is known that P-gp inhibition has a significant effect on the absorption.
**Other interactions (28):**
- Concomitant use with ACE and mineralcorticoid receptor inhibitors Coadministration of sparsentan with mineralocorticoid (aldosterone) receptor inhibitors such as spironolactone and finerenone is...
- There are no data on the combination of sparsentan with ACE inhibitors such as enalapril or lisinopril.
- Clinical trial data has shown that dual blockade of the reninangiotensinaldosteronesystem (RAAS) through the combined use of ACE inhibitors, angiotensin II receptor blockers or aliskiren is...
- The use of sparsentan in combination with ACE inhibitors such as enalapril or lisinopril should be done with caution, and blood pressure, potassium, and kidney function should be monitored (see...
- Concomitant use with potassium supplements and potassium-sparing diuretics As hyperkalaemia may occur in patients treated with medicinal products that antagonise the angiotensin II receptor type 1...
- Effect of other medicinal products on sparsentan Sparsentan is primarily metabolised by cytochrome P450 (CYP)3A.
Pregnancy
Avoid (toxicity in animal studies). M
Breast feeding
Avoid (no information available). M
Hepatic impairment
Caution in moderate impairment (limited information available); avoid in severe impairment (no information available) or if serum transaminases exceed 2 times the upper limit of normal (limited information available). M
Renal impairment
Avoid if eGFR less than 30 mL/minute/1.73 m 2 (limited information available). M See Prescribing in renal impairment .
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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